scholarly journals A CLINICAL STUDY OF RISK FACTORS AND MATERNAL OUTCOME IN INTRA-UTERINE FETAL DEATH

Author(s):  
Anubha Manu Prasad ◽  
. Manju Agrawal ◽  
Ankit Laddha

Background: The objective of the present study was to examine the etiological factors, both maternal and fetal, that caused IUFD. Methods: It was a hospital based prospective observational study conducted in the Department of Obstetrics and Gynaecology at Jhalawar Medical College from January 2020 to December 2020. 120 cases of IUFD of ?24 weeks of gestation or foetuses weighing ?500 gramswere included in the study. Results: The incidence of IUFD was 37.8/1000 total birth. IUFD occurredmainly in 25-35yrs age group (55%), unbooked cases (70%),multigravida (59.2%), preterm (<37 weeks of gestation). The risk factors were PIH (49.2%), infections (9.2%), hypothyroidism (5%), Rh negative with hydrops fetalis (5%),GDM (4.2%), chronic hypertension (2.5%), previous H/O LBW (2.5%), H/O prior stillbirth (5%), hyperthyroidism (1.7%), oligohydramnios (46.7%), APH (20.8%) and congenital fetal anomalies (19.2%). Conclusion: IUFD rate still remains high. Therefore, regular ANC check up and early identification of risk factors like PIH, anaemia, infections, genetic counselling and timely referral to well equipped centre may help prevent IUFD and maternal mortality and morbidity. Keywords: IUFD, ANC, Preterm

Author(s):  
Sunil Kumar Pandey ◽  
Surabhi Porwal

Background: Intrauterine foetal death is an immense emotional burden for everyone concerned specially in the last trimester. Therefore, it is very important to find out, what has happened. Evaluation of clinical and pathological profile of women presenting with intrauterine foetal death has evoked great interest among the obstetricians.Methods: The prospective observational study was conducted in the department of Obstetrics and Gynaecology N.S.C.B. Medical College Jabalpur during 1st June 2012 to 31st October 2013. A total of 155 intrauterine foetal death subjects admitted during this period were evaluated. Clinically and laboratory profile of subjects done.  Histomorphology of placenta was performed in each case. Full HPR finding were then correlated with clinical and laboratory findings of subjects.  Results: Poor vascularity of villi and fever were significantly associated (p<0.01). Hypertension and Convulsion and fibrinoid necrosis, syncytial knot and placental infarcts were significantly associated (p<0.001) Premature placenta is associated with cytotrophoblastic layer (p<0.01). Conversely post mature placenta is associated with calcification and infarction.  (p<0.01).  Conclusions: All placentae associated with foetal death have either gross or microscopic abnormalities. Present study is a step towards understanding and extrapolating the already known causes of intrauterine foetal death in the perspective of Jabalpur and its adjoining districts.


2018 ◽  
Vol 5 (5) ◽  
pp. 1781 ◽  
Author(s):  
Atul Kumar Singh ◽  
Rajeev Dwivedi ◽  
A. P. S. Ghaharwar

Background: Peripheral venous canualation is indispensable in admitted patients in surgical ward, thrombophlebitis following infusion is seldom serious, but it effects on postoperative recovery, hospital stay and hence burden of disease are magnanimous. The main aim and objective of the study to find out the incidence of thrombophlebitis at the intravenous infusion site in surgical ward.Methods: This prospective observational study was conducted on 300 patients admitted in surgical ward of S.S Medical College and associated S.G.M. hospital, Rewa (M.P.) patients selected randomly. These Patients were visited daily for any sign and symptoms at infusion site. The incidence of thrombophlebitis according to age, sex and duration of infusion were recorded. The tool designed to collect the data were socio demographic performa and observational check list.Results: In total 300 patients the incidence of thrombophlebits is highest in age group of 41-50(20%), Male (64.66%) and incidence increases as the duration of infusion increased it is 100% after 5 days. The incidence of Grade -1 thrmbophlebitis (71.33%) is higher as compared to Grade- 2 (22.67%).Conclusions: Thrombophelebitis is still an important ongoing problem in admitted patients in surgical ward. Incidence of grade-I thrombophlebitis is higher. It is more in male in the age group of 40-50 and duration of infusion is main causative factor for development of thrombophlebitis.


Author(s):  
Subha Sivagami Sengodan ◽  
Mohana Dhanapal

Background: Abruptio placenta is separation of a normally situated placenta after 20 weeks of gestation and prior to the birth of the fetus. It is an important cause of antepartum haemorrhage and presents as an acute abdomen in the third trimester of pregnancy. Obstetrical haemorrhage is one of the triad (Haemorrhage hypertension and infection) of causes of maternal deaths in both developed and underdeveloped countries.Methods: This is a retrospective study of Abruptio Placenta cases carried out between January 2015 and December 2015 at Government Mohan Kumaramangalam Medical College Hospital, Salem and about its perinatal and maternal outcome.Results: Incidence of Abruptio placenta is 0.5%. It is most common in the women of age group 26-30yrs. 67% of cases were associated with severe pre-eclampsia. Live births were 69.8% while stillbirths were 30.2%. PPH occurred in 19.6% of cases. DIC accounts for 16.7% of the complication.Conclusions: Abruptio placenta is associated with poor maternal and fetal outcome. Hence early diagnosis and prompt resuscitative measures would prevent both perinatal and maternal mortality and morbidity.


2021 ◽  
pp. 13-17
Author(s):  
Rabindra Nath Behera ◽  
Sini Venugopal ◽  
Avilas Das

Objective : This is a Prospective cohort study carried out in department of Obstetrics and Gynaecology, Hi-Tech Medical College & Hospital, Bhubaneswar, a tertiary care centre, with the objective of knowing the etiology and outcome of preterm labour and formulate measures to prevent the onset of preterm labour and deal with complications arising from preterm labour. Materials and methods : A total of 112 patients with preterm labour were included in the study. The investigations required to identify the etiology and also other routine investigations were carried out . The study was conducted over a two year period i.e. from November 2018 to October 2020 at Hi-Tech Medical College & Hospital, Bhubaneswar. Results : Majority of the patients were in the age group of 20-24 years. Among them, majority of the patients belonged to the gestational age group of 28-34 weeks . Infection was the commonest cause of preterm labour. There is signicant improvement in neonatal outcome in steroid covered group if gestational age is less than 34 weeks . Conclusion: Preterm labour has major impact on neonatal mortality and morbidity. Hence identication of risk factors and etiologies of preterm labour and timely interventions in the form of investigations and management and preparedness to tackle the maternal and neonatal complications are vital for a good maternal and neonatal outcome.


Author(s):  
Ritu Mishra ◽  
Aditya Prakash Misra

Background: Abruptio placenta is one of the common cause of antepartum haemorrhage and is defined as premature separation of normally implanted placenta. It is more common in second half of pregnancy. Abruptio placenta is serious complication of pregnancy and causes high maternal and neonatal morbidity and mortality.Methods: This retrospective study of abruptio and its maternal and perinatal outcome was carried out between July 2016 and October 2017 at Rama Medical College Hospital and research centre.Results: Incidence of Abruptio placenta is 1.6%. It is most common in the women of age group 30-35 years. 75% of cases were associated with severe pre-eclampsia. Live births were 75% while stillbirths were 25%. PPH occurred in 30% of cases. DIC accounts for 25% of the complication.Conclusions: Abruptio placenta is life threatening complication of pregnancy and it is associated with poor maternal and fetal outcome if not managed appropriately. Hence early diagnosis and prompt resuscitative measures would prevent both perinatal and maternal mortality and morbidity.


Author(s):  
Isha . ◽  
Prabha Lal ◽  
Vikram Dutta ◽  
Aayushi Kaushal

Background: Incidence of caesarean section is rapidly rising over the last two decades and 25% is contributed by second stage caesarean section. Demographic factors influencing fetomaternal outcome in second stage caesarean section include BMI, socioeconomic status, booking/ unbooking status, gravidity and maternal height.Methods: The present study was prospective observational study conducted in the department of obstetrics and gynaecology at Lady Hardanger Medical College New Delhi from December 2015 to March 2017. 80 women were enrolled in the study. A detailed history and examination of each patient was carried out. Women were observed during lab our till second stage caesarean section.Results: Mean age of population was 25.26±3.75 ranging from 19-40 year. 76.25% included in study were booked and 11.25% were unbooked, 42.5% belonged to lower middle class and 31.25% belonged to upper middle class. 47% women had height of <150 cm and 70% had a BMI between (25-29.9) kg/m. 43% women had gestational age between 39-40 weeks.Conclusions: Second stage caesarean section was more common in young age group and primigravidae. Higher BMI was not only operative but obstetrical risk as well.


Author(s):  
Somika Kaul ◽  
Bijal D. Rami

Background: Breech presentation is the commonest of all mal presentations. Vaginal delivery of breech presentation at term is associated with a much higher perinatal mortality and morbidity than that of vertex presentation.Methods: This prospective study was carried out in the department of obstetrics and gynaecology, S. S. G. Hospital, Baroda for a period of six months from 1st May 2019 to 31st October 2019. Out of a total number of 4476 deliveries, 159 were breech pregnancy. It included all the women admitted in labour room or ward who delivered with clinical or ultrasound diagnosis of breech presentation after 20 weeks of gestation.Results: In the present study incidence of breech pregnancy was 3.6%. Authors observed the highest incidence of breech pregnancy in the age group of 20 to 25 years. Maximum (62.9%) cases delivered after 37 weeks of gestation. In our study 62.3% cases were primigravida and 37.7% were multigravida. Majority of cases (77.4%) delivered by caesarean section. Among all the babies born 50.6% were having birth weight of less than 2.5 kg.Conclusions: Authors need to study and analyse all cases of breech pregnancy individually to decide the management and mode of delivery depending on cases to case basis and expertise of the staff available. Delivery of breech foetus should be conducted by experience obstetrician after appropriate consent from pregnant women and her relatives.


Author(s):  
Kamrun Nessa ◽  
Sumia Bari ◽  
Sanjida Khan ◽  
Ferdowsi Sultana ◽  
Tania Akbar

Background: Globally postpartum haemorrhage remains a leading cause of maternal death. It affects only 1-2% of postnatal women. This low incidence of secondary PPH and linkage to maternal morbidity rather than mortality was the reason for the little attention among obstetricians, but it is recently gaining importance and interest with the increase morbidity and mortality related to secondary PPH.Methods: A retrospective study was conducted on the diagnosed patients of secondary PPH admitted in Enam Medical College and Hospital, Dhaka, Bangladesh, from January 2015 to December 2016. Among 33 cases of secondary PPH age of the patients, parity, mode of delivery, causes and management were noted from medical records. All data was analyzed by SPSS16.Results: Among 33 patients 14 (42.4%) were primi and 19 (57.6%) were multipara, age between 18 to 38 years, majority admitted 2nd and 3rd week after delivery. Among 33 patients 12% delivered vaginally at home and 30% vaginally at hospital and 58% undergone LUCS. We found 34% retained bits of placenta, 27% uterine wound dehiscence, 24% retained clots and 15% endometritis as causes. Less than 3 units blood needed in 22 (66.7%) patients and 11 (33.3%) needed more than 3 units. About 6 (18%) patients were treated conservatively, MVA were needed in 18 (55%) patients, repair of wound in 4 (12%) and TAH was in 5 (15%).Conclusions: Secondary PPH is increasing may result in significant maternal morbidity as well as mortality. More study needed to identify the risk factors and causes to reduce maternal mortality and morbidity.


1970 ◽  
Vol 3 (2) ◽  
pp. 122-125 ◽  
Author(s):  
AEMM Islam ◽  
M Faruque ◽  
AW Chowdhury ◽  
HIR Khan ◽  
MS Haque ◽  
...  

Background: Coronary artery diseases are one of the major challenges faced by cardiologists. Control of certain risk factors for CAD is associated with decrease in mortality and morbidity from myocardial infarction and unstable angina. So, identification and taking appropriate measures for primary and secondary prevention of such risk factors is, therefore, of great importance. This retrospective study was carried at the newly set up cath lab in Dhaka Medical college. Materials and Methods: Total 228 consecutive case undergone diagnostic coronary angiogram from 10th January 2007 to31st January 2009 out of which 194(80%) were male and 34 (20%) were female. In both sexes most of the patients were between 41 to 60 years of age. Risk factors of the patients were evaluated. Results: In females commonest risk factor was Diabetes (58.8%) followed by dyslipidaemia (35.3%). In males commonest risk factor was hypertension (30.9%) followed by smoking (29.9%) and diabetes (28.3%). In males 44.3% patients presented with acute myocardial infarction followed by stable angina (43.3%); but in females stable angina was the commonest presentation (50.0%) followed by myocardial infarction (38.2%).CAG findings revealed that in males 33.5% had double vessel disease 26.8% followed by single vessel 26.8% and multivessel disease 25.3%. In females normal CAG was found in 35.5% followed by double vessel 23.5%, multivessel 20.6% and single vessel 20.6%. On the basis of CAG findings; in males 41.8% patients were recommended for CABG, followed by PTCA & stenting 26.3% and medical therapy 30.0%; where as in females 55.9% were recommended for medical therapy , followed by CABG 32.4% and PTCA & stenting11.8%. Conclusion: The commonest presentation of CAD was 4th and 5th decades in both sexes. Diabetes and dyslipidaemia were more common in females whereas hypertension and smoking were more common in males. Myocardial infarction and stable angina were most common presentation in both sexes though in males myocardial infarction was more common. In males the angiographic severity of CAD was more and they were more subjected for CABG in comparison to females. Key words: Risk factors; Coronary angiography. DOI: http://dx.doi.org/10.3329/cardio.v3i2.9179 Cardiovasc. J. 2011; 3(2): 122-125


2020 ◽  
pp. 60-62
Author(s):  
Narendra Nath Hait ◽  
Brahmarshi Das ◽  
Ratan Chandra Mandal ◽  
Haricharan Roy ◽  
Debarshi Jana

Background: Threatened abortion is till most common cause of early trimester bleeding PV and can be diagnosed and managed by early USG diagnosis. Materials and methods: This was a prospective observational study. Place of the study was Department of Obstetrics and Gynaecology and Department of Radiodiagnosis, Midnapore Medical College and Hospital from January 2019 to June 2020. Eighteen months. Result: When the clinical method to diagnose threatened miscarriage was compared to the sonographic method, it was evident that sonographic method was reliable than the clinical method and the difference was statistically significant. Conclusion: In case of missed miscarriage and complete miscarriage, although the percentage of discrepancy was 100%, on further statistical analysis, the discrepancy was not statistically significant. And the cause behind this was probably inadequate sampling.


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